Gynecomastia Evaluation and Management Clinical Practice Guidelines (2019)

European Academy of Andrology

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

June 04, 2019

In May 2019, the European Academy of Andrology (EAA) released clinical practice guidelines on the assessment and management of gynecomastia.[1]

In adults with gynecomastia, be aware that an underlying pathology may be present. It is recommended that even when an apparent reason for the gynecomastia, such as the use of medication linked to gynecomastia development, has been identified in an adult, a detailed investigation not be precluded.

It is recommended that details on the onset and duration of gynecomastia, sexual development and function, and the use or abuse of substances linked to gynecomastia be included in the patient's medical history.

It is recommended that the presence of palpable glandular tissue be confirmed through breast examination in order to differentiate gynecomastia from lipomastia (pseudogynecomastia) and exclude the possibility that a malignant breast tumor exists.

It is recommended that the genitalia be examined during the physical examination in order to determine whether a palpable testicular tumor is present or testicular atrophy has occurred.

Since palpation has low sensitivity for testicular tumor detection, it is recommended that testicular ultrasonography also be employed in genital examination.

Once the underlying pathology for gynecomastia has been treated or the use/abuse of substances linked to gynecomastia has ceased, watchful waiting is recommended.

It is recommended that only men with proven testosterone deficiency be offered testosterone therapy.

It is not recommended that selective estrogen receptor modulators, aromatase inhibitors, and non‐aromatizable androgens generally be used in gynecomastia treatment.

For more information, please go to Gynecomastia.

For more Clinical Practice Guidelines, please go to Guidelines.


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